在冠状动脉手术中，比较分析凝血酶原复合物浓缩物和新鲜冷冻血浆。
Comparative Analysis of Prothrombin Complex Concentrate and Fresh Frozen Plasma in Coronary Surgery.
机构信息
Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland; Department of Surgery, Oulu University Hospital and University of Oulu, Oulu, Finland.
Division of Cardiothoracic and Vascular Surgery, Robert Debré University Hospital, Reims, France.
出版信息
Heart Lung Circ. 2019 Dec;28(12):1881-1887. doi: 10.1016/j.hlc.2018.10.025. Epub 2018 Dec 11.
BACKGROUND
Recent studies suggested that prothrombin complex concentrate (PCC) might be more effective than fresh frozen plasma (FFP) to reduce red blood cell (RBC) transfusion requirement after cardiac surgery.
METHODS
This is a comparative analysis of 416 patients who received FFP postoperatively and 119 patients who received PCC with or without FFP after isolated coronary artery bypass grafting (CABG).
RESULTS
Mixed-effects regression analyses adjusted for multiple covariates and participating centres showed that PCC significantly decreased RBC transfusion (67.2% vs. 87.5%, adjusted OR 0.319, 95%CI 0.136-0.752) and platelet transfusion requirements (11.8% vs. 45.2%, adjusted OR 0.238, 95%CI 0.097-0.566) compared with FFP. The PCC cohort received a mean of 2.7±3.7 (median, 2.0, IQR 4) units of RBC and the FFP cohort received a mean of 4.9±6.3 (median, 3.0, IQR 4) units of RBC (adjusted coefficient, -1.926, 95%CI -3.357-0.494). The use of PCC increased the risk of KDIGO (Kidney Disease: Improving Global Outcomes) acute kidney injury (41.4% vs. 28.2%, adjusted OR 2.300, 1.203-4.400), but not of KDIGO acute kidney injury stage 3 (6.0% vs. 8.0%, OR 0.850, 95%CI 0.258-2.796) when compared with the FFP cohort.
CONCLUSIONS
These results suggest that the use of PCC compared with FFP may reduce the need of blood transfusion after CABG.
背景
最近的研究表明，与新鲜冷冻血浆（FFP）相比，凝血酶原复合物浓缩物（PCC）可能更有效地减少心脏手术后红细胞（RBC）的输血需求。
方法
这是一项对 416 例术后接受 FFP 治疗和 119 例单独冠状动脉旁路移植术（CABG）后接受 PCC 加或不加 FFP 治疗的患者进行的比较分析。
结果
混合效应回归分析调整了多个协变量和参与中心，结果表明 PCC 显著降低 RBC 输血（67.2%对 87.5%，调整后的 OR 0.319，95%CI 0.136-0.752）和血小板输血需求（11.8%对 45.2%，调整后的 OR 0.238，95%CI 0.097-0.566）与 FFP 相比。PCC 组平均输注 2.7±3.7（中位数，2.0，IQR 4）单位 RBC，FFP 组平均输注 4.9±6.3（中位数，3.0，IQR 4）单位 RBC（调整系数，-1.926，95%CI-3.357-0.494）。与 FFP 组相比，PCC 的使用增加了 KDIGO（肾脏疾病：改善全球结果）急性肾损伤的风险（41.4%对 28.2%，调整后的 OR 2.300，1.203-4.400），但不增加 KDIGO 急性肾损伤 3 期（6.0%对 8.0%，OR 0.850，95%CI 0.258-2.796）的风险。
结论
这些结果表明，与 FFP 相比，PCC 的使用可能会减少 CABG 后的输血需求。
Zotero 插件